电话回访机制在重性精神障碍全病程综合干预中的应用

Telephone Interviews Mechanism in the Course of Comprehensive Intervention of Severe Mental Disorders

目的研究系统的电话随访在重性精神障碍患者全病程干预中的作用。方法将患者分为研究组和对照组,既往出院后未进行电话随访的患者为对照组,出院后即开始进行系统的电话随访的患者为研究组,两组在出院1年后进行对比,总体印象量表(CGI)、社会功能、医嘱的依从性、1年内的复发率、再住院率以及肇事肇祸危险等级评定等作为评价指标。结果研究组干预1年后与对照组各指标比较,总体印象量表病情严重程度SI(χ2=1370.259,P<0.001)、疗效总评GI(χ2=1232.43,P<0.001)、残疾等级比较(χ2=1048.426,P<0.001)、危险等级比较(χ2=17.23,P<0.01)、治疗的依从性比较(χ2=890.428,P<0.001),1年后疾病复发人次比较(χ2=426.49,P<0.001),出院1年后的再住院人次(χ2=284.64,P<0.001),两组各指标差异具有统计学意义,研究组明显优于对照组。结论电话随访可以建立良好的医患关系,提供系统和有针对性的健康教育、心理咨询,帮助患者建立家庭和社会支持系统,提高患者治疗的依从性和社会功能,减少复发率和肇事肇祸行为,是一种有效的干预手段。

Objective To study the systematic telephone interviews in the whole course of severe mental disorders. Methods The control group：Discharged without telephone interviews of patients;the study group：Telephone interviews mechanism were us- ing for patients in the course of comprehensive intervention. The two groups compared after one year,the CG1 overall impression Scale,social function ,compliance,recurrence rate within one ye^r,readmission rate ,and the risk of accident rating as the evaluation index. Results After one year,the study group were better than the observation group in the overall impression of the severity of the disease the SI （Z2 = 1370. 259 ,P^0. 00001 ） ,efficacy overall GI（Zz = 1232.43 ,P^0. 00001 ） ;disability grade （Z2 = 1（~48. 426 ,P d0. 00001 ） ;danger rating（X2 = 17.23,P%0.01） ;adherence to treatment （：g2 = 890. 428 ,P%O. 0001） ;disease recurrence after one year Cg2~426.49,P%0. 0001）;discharged after one year and then inpatientsCg2=284. 64,P%0. 0001）： Conclusion The tele- phone interviews is an effective means of intervention,which can establish a good doctor-patient relationship,provide a systematic and targeted health education,psychological counseling,to help build family and social support systems,improve adherence to treat- ment and social function of patients and reduce the relapse rate and accident of behavior.